There are currently few standards around how the health management industry discusses and measures effectiveness. However, this is about to change.
HealthFitness’ Ed Framer, Ph.D., director of health and behavioral sciences, is the co-leader of a collaborative project between the Care Continuum Alliance and the Health Enhancement Research Organization to develop standard metrics for employee health. At the World Congress Wellness & Prevention 3.0 Conference, May 8-9, 2013, he presented an update on the project and project scope.
Developing core metrics for employee health management
Developing a Core Setof Metrics for EmployeeHealth Management
Background• Employer members asked HERO to initiatework to create a core set of metrics that allsuppliers would measure• In February, 2011, HERO and Care ContinuumAlliance met to outline a collaborative approachto address this need• Our belief is this is a requirement as the healthmanagement industry matures• Our hope is to include all non-profitorganizations in supporting these recommendedmetrics
The Health EnhancementResearch Organization (HERO) Non-profit 501(c)3 founded in1996HERO Vision is to promote aculture of health and performancethrough employer leadershipHERO Mission is to promote ahealthy and high-performingworkforce through evidence-basedhealth management as a corebusiness imperativeABOUT HERO ACTIVITIESCOMPANY OVERVIEW
4The Voice of the Population Health Industry• Conducts research• Advocates on behalf of a population healthimprovement model for better health outcomes andcontrolling health care costs• Represents stakeholders along the continuum of care:employers, providers, insurers, brokers, technologydevelopers, benefits consultants• Common goal: improving care coordination, riskstratification, quality and accountability through patientand physician engagement and better use of technology
Project Objectives• Clinical judgment and (versus) quality processes• Create a complete and consistent set of EHMmeasures and standards to facilitate processimprovement• Measures and standards are necessary to takeadvantage of the window of opportunity tomove the industry forward• Measures and standards will help us completethe transition from clinician-based programs todata-driven, health improvement processes
Collaborating OrganizationsActiveHealth Management Johnson & JohnsonAetna Kaiser PermanenteAlere Mayo Health SolutionsAllOne Health MercerAmerican Specialty Health Midwest Business Group on HealthAPS Healthcare National Business Group on HealthBoeing NCQACapital Blue Cross NQFCare Continuum Alliance NurturCMI Media Onlife HealthEthicon Endo-Surgery OptumHealtheVive Health PrudentialGeisinger RAND CorporationHealth 2 U / HCA Redbrick HealthHealth Dialog Riedel & Associates ConsultantsHealth Improvement Solutions,Inc. StayWell Health ManagementHealthFitness Truven Health AnalyticsHealthStat University of AlabamaHERO University of MichiganHooper Holmes URACHuman Resources Institute WebMDIHPM WellSteps
Project StructureOrganizationalSupportHealth Impact Satisfaction ParticipationFinancialOutcomesProductivity &PerformanceVALUE ON INVESTMENT
DEFINING THE DOMAINS Value on Investment: Direct, indirect and tangential costs, financial outcomesand defining a value framework Financial Outcomes: Health care cost (medical and pharmacy), absence, disability, workerscompensation Health Impact: Change in health status associated with preventable health conditions andresulting from health promotion program participation Organizational Support: The degree to which an organization commits to the health and well-being of its employees. Participation: Evaluate participation in EHM programs that can be associated with producing apositive impact on health-related outcomes Productivity & Performance: Quantifies worker presence at work, both physically and mentally Satisfaction: Client satisfaction, participant satisfaction
The Work ProductFor each of the seven domains:• Definition of each domain• Evaluation of existing measures and overarchingissues• Recommended measuresRecommendedstandards (whereenough evidence existsto make arecommendation)
Value on Investment• Ultimately, all other metrics feed into VOI• Each employer’s circumstances (size, health benefitstructure, program scope, cost, etc.) will dictate thatsomewhat different elements and weighting willcontribute to program evaluation.• Question: How to balance disparate measures, varyingdegrees of certainty regarding outcomes, and specificemployer needs and values to arrive at a sensibleassessment of program value?• The VOI workgroup has created a framework foranswering this question.
Organizational SupportScope: The degree to which an organization commitsto the health and well-being of its employees.Key Elements•Company stated health values•Health-related policies•Supportive environment•Organizational structure•Leadership support•Resources & strategies•Employee involvement•Rewards & recognition
Health ImpactScope• A minimum set of measures and metrics• Intended to capture the majority of thevariance in the change in health status• Associated with preventable health conditions• Resulting from health promotion programparticipation.Key Elements• Physical health• Mental/emotional health• Health behaviors
Participant & Client SatisfactionScope: Propose and define measures and metricsof Participant and Client SatisfactionKey Elements - Participant•Overall satisfaction (including Loyalty)•Effectiveness•Scope•Convenience•Communications•Member Experience•Cost•BenefitsKey Elements - Client• Overall satisfaction (includingLoyalty)• Effectiveness• Value• Scope• Member Experience• Account Management• Reporting
ParticipationScope• Recommend definitions and measures to evaluateparticipation in EHM programs• Participation is closely aligned with active vs. passiveinvolvement in an EHM programKey ElementsContacts are two-way interactions, whether they are:• In-person• By phone• Via web-technology interface• Via a combination of modalities
Financial OutcomesScope: Measures and guidancefor employers to evaluate thehealthcare claims cost impact oftheir EHM program.Key Elements•Appropriateness of direct claims•Measuring and reporting fiscal savings•Guidance on working with analysts•Strengths and weaknesses of common methods
Productivity & PerformanceScope: Quantify worker presence at work,both physically and mentally.Key Elements•Worker presence/absence•Worker output and performance while at work